Organization
DE ANZA SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD J TENNANT CASC (CEO/ADMINISTRATOR)
(951) 320-7799
Entity
Organization
Contact information
Practice address
4444 MAGNOLIA AVE, SUITE C, RIVERSIDE, CA 92501-4136
(951) 320-7799
(951) 274-3550
Mailing address
4444 MAGNOLIA AVE, SUITE C, RIVERSIDE, CA 92501-4136
(951) 320-7799
(951) 274-3550
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
250000795
CA
Other
Enumeration date
01/03/2006
Last updated
10/09/2008
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